MEDICARE: STEPHEN DANIEL CRIPPEN MA, LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	LF00001982	WA

General Provider Information

NPI Number	:	1275687022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN DANIEL CRIPPEN MA, LMFT

Provider Business Mailing Address
First Line	:	1405 NW 85TH ST
Second Line	:	STE 4
City	:	SEATTLE
State	:	WA
Zip	:	98117-4237
Country	:	US
Telephone Number	:	206-214-7650
Fax Number	:

Provider Business Practice Location Address
First Line	:	1405 NW 85TH ST
Second Line	:	STE 4
City	:	SEATTLE
State	:	WA
Zip	:	98117-4237
Country	:	US
Telephone Number	:	206-214-7650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	08/17/2007

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